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https://www.readbyqxmd.com/read/28551929/-early-in-hospital-mortality-in-internal-medicine-wards-within-24-hours-a-potential-quality-indicator-or-a-variable-affected-by-multiple-factors
#1
Yaron Niv, Evgeny Berkov, Pazit Kanter, Evgeny Abrahmson, Uri Gabbay
AIMS: To evaluate in-hospital mortality rate within 24 hours in internal medicine wards and to evaluate if it may be used as quality indicator. BACKGROUND: In-hospital mortality rate is an outcome measure which apparently reflects quality of care. There are debates on whether it may be considered a quality indicator since it is difficult to compare different case-mixes between hospitals. Research on mortality within 24 hours had not been published. METHODS: An historical prospective study was conducted including the entire internal wards admissions to the Rabin Medical Center between 1/7/14 and 30/6/15...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28551445/decreasing-post-operative-narcotics-in-reconstructive-pelvic-surgery-a-randomized-controlled-trial
#2
Krista Ml Reagan, David M O'Sullivan, Richard Gannon, Adam C Steinberg
BACKGROUND: Post-operative pain control is crucial to any successful recovery plan. Many currently used medication regimens are narcotic-focused. OBJECTIVE: The objective of our study was to evaluate the efficacy of a multi-modal pain regimen after pelvic reconstructive surgery. STUDY DESIGN: The primary outcome measure was narcotic use. Secondary outcomes included pain, nausea and constipation. Patients were randomized to either a "usual care" post-operative treatment regimen or a multimodal pain regimen...
May 24, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28551423/safety-and-predictors-of-next-day-discharge-after-elective-transfemoral-transcatheter-aortic-valve-replacement
#3
Sulaiman Rathore, Yevgeniy Latyshev, Sheree Emore, Joseph Rowe, Jason Foerst
OBJECTIVES: We sought to determine the predictors of next-day discharge (NDD) for selected patients undergoing elective transfemoral transcatheter aortic valve replacement (TF-TAVR). BACKGROUND: Techniques have rapidly evolved over the last several years to simplify TF-TAVR allowing for a subset of patients to be discharged the next day. METHODS: Baseline and procedural characteristics, in-hospital and 30-day follow-up outcomes, complications and readmission rates of 100 TF-TAVR cases were assessed...
May 19, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28551089/prognosis-at-6-and-12months-after-self-attempted-hanging
#4
Guillaume Gantois, Erika Parmentier-Decrucq, Thibault Duburcq, Raphaël Favory, Daniel Mathieu, Julien Poissy
INTRODUCTION: Patients surviving a self-attempted hanging have a total neurological recovery in 57-77% of cases at hospital discharge, but no long-term data are available. METHODS: In this observational study, all patients hospitalized post-self-attempted hanging in the intensive care unit (ICU) in a 5-year period were included. Neurological evaluations at 6 and 12months were performed according to Cerebral Performance Category (CPC) scores. Factors associated with neurological recovery were determined by comparing CPC2+3+4 (bad recovery) vs...
May 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28550999/process-mining-routinely-collected-electronic-health-records-to-define-real-life-clinical-pathways-during-chemotherapy
#5
Karl Baker, Elaine Dunwoodie, Richard G Jones, Alex Newsham, Owen Johnson, Christopher P Price, Jane Wolstenholme, Jose Leal, Patrick McGinley, Chris Twelves, Geoff Hall
BACKGROUND: There is growing interest in the use of routinely collected electronic health records to enhance service delivery and facilitate clinical research. It should be possible to detect and measure patterns of care and use the data to monitor improvements but there are methodological and data quality challenges. Driven by the desire to model the impact of a patient self-test blood count monitoring service in patients on chemotherapy, we aimed to (i) establish reproducible methods of process-mining electronic health records, (ii) use the outputs derived to define and quantify patient pathways during chemotherapy, and (iii) to gather robust data which is structured to be able to inform a cost-effectiveness decision model of home monitoring of neutropenic status during chemotherapy...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28550756/reduction-of-medical-hospitalizations-in-veterans-with-schizophrenia-using-home-telehealth
#6
Leah R Flaherty, Karin Daniels, Jim Luther, Gretchen L Haas, John Kasckow
This study tested the hypothesis that addition of telehealth to Intensive Case Monitoring (ICM) would reduce hospital admissions in Veterans with schizophrenia or schizoaffective disorder admitted for psychiatric care in response to suicidal behavior. Participants (n =51) were randomized to ICM or ICM plus telehealth monitoring. Telehealth participants responded to daily electronic queries about depression, suicidality, and medication adherence. Comparisons revealed that participants in the telehealth group had significantly less medical hospitalizations than the control group...
May 16, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28550702/listening-to-improve-transforming-patient-relations-measurement-and-reporting-in-ontario
#7
Patricia Sullivan-Taylor, Rachel Frohlich, Anita Singh, Anna Greenberg
Effective patient relations are important to improve patient experience and deliver better care. Policy and legislative changes in Ontario have increased accountabilities for patient relations and expanded Health Quality Ontario (HQO)'s mandate. In response, HQO collaborated with patients, health sector organizations, associations and the Ministry of Health and Long-Term Care to co-design a patient relations measurement and reporting approach. Informed by an environmental scan, broad consultations, a multi-sector survey and a provincial advisory group, the approach includes standardized patient relations indicators to support measurement and public reporting across the hospital, home and long-term care sectors...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550699/the-poet-prevention-of-error-based-transfers-project
#8
Jill Oliver, Paula Chidwick
The PoET (Prevention of Error-based Transfers) Project is one of the Ethics Quality Improvement Projects (EQIPs) taking place at William Osler Health System. This specific project is designed to reduce transfers from long-term care to hospital that are caused by legal and ethical errors related to consent, capacity and substitute decision-making. The project is currently operating in eight long-term care homes in the Central West Local Health Integration Network and has seen a 56% reduction in multiple transfers before death in hospital...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550698/boomr-better-coordinated-cross-sectoral-medication-reconciliation-for%C3%A2-residential-care
#9
Vincent Vuong, Denis O'Donnell, Hrishikesh Navare, Debra Merrill, Michal Racki, Sheila Burton, Lori Anderson, Carla Beaton
There is evidence that medication errors often arise during the transition of residents from acute care to long-term care (LTC) homes due to lapses in communication and documentation. Better Coordinated Cross-Sectoral Medication Reconciliation (BOOMR) is an integrated practice change improving medication safety during patient transitions through the health system. Our Medication Reconciliation (MedRec) redesign improved patient engagement using "the patient's story," increased quality of information, workflow efficiency and reduced unnecessary medications...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550610/association-between-patient-centered-medical-home-capabilities-and-outcomes-for-medicare-beneficiaries-seeking-care-from-federally-qualified-health-centers
#10
Justin W Timbie, Peter S Hussey, Claude M Setodji, Amii Kress, Rosalie Malsberger, Tara A Lavelle, Mark W Friedberg, Suzanne G Wensky, Katherine D Giuriceo, Katherine L Kahn
BACKGROUND: Patient-centered medical home (PCMH) models of primary care have the potential to expand access, improve population health, and lower costs. Federally qualified health centers (FQHCs) were early adopters of PCMH models. OBJECTIVE: We measured PCMH capabilities in a diverse nationwide sample of FQHCs and assessed the relationship between PCMH capabilities and Medicare beneficiary outcomes. DESIGN: Cross-sectional, propensity score-weighted, multivariable regression analysis...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28550459/patterns-of-drug-prescriptions-in-an-orthogeriatric-ward-as-compared-to-orthopaedic-ward-results-from-the-trondheim-hip-fracture-trial-a-randomised-clinical-trial
#11
Marianne Heltne, Ingvild Saltvedt, Stian Lydersen, Anders Prestmo, Olav Sletvold, Olav Spigset
PURPOSE: In the Trondheim Hip Fracture Trial, 397 home-dwelling patients with hip fractures were randomised to comprehensive geriatric care (CGC) in a geriatric ward or traditional orthopaedic care (OC). Patients in the CGC group had significantly better mobility and function 4 months after discharge. This study explores group differences in drug prescribing and possible associations with the outcomes in the main study. METHODS: Drugs prescribed at admission and discharge were registered from hospital records...
May 26, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28550260/living-alone-with-alzheimer-s-disease-data-from-svedem-the-swedish-dementia-registry
#12
Pavla Cermakova, Maja Nelson, Juraj Secnik, Sara Garcia-Ptacek, Kristina Johnell, Johan Fastbom, Lena Kilander, Bengt Winblad, Maria Eriksdotter, Dorota Religa
BACKGROUND: Many people with Alzheimer's disease (AD) live alone in their own homes. There is a lack of knowledge about whether these individuals receive the same quality of diagnostics and treatment for AD as patients who are cohabiting. OBJECTIVES: To investigate the diagnostic work-up and treatment of community-dwelling AD patients who live alone. METHODS: We performed a cross-sectional cohort study based on data from the Swedish Dementia Registry (SveDem)...
May 25, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#13
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28549706/long-term-effectiveness-of-a-multifactorial-fall-and-fracture-prevention-program-in-bavarian-nursing-homes-an-analysis-based-on-health-insurance-claims-data
#14
Claudia Schulz, Ivonne Lindlbauer, Kilian Rapp, Clemens Becker, Hans-Helmut König
OBJECTIVE: Femoral fractures are frequently consequences of falls in nursing homes and are associated with considerable costs and unfavorable outcomes such as immobility and mortality. The purpose of this study was to examine the long-term effectiveness of a multifactorial fall and fracture prevention program in nursing homes in terms of reducing femoral fractures. DESIGN: Retrospective cohort study. SETTING: Nursing homes. PARTICIPANTS: Health insurance claims data for 2005-2013 including 85,148 insurants of a sickness fund (Allgemeine Ortskrankenkasse Bayern), aged 65 years or older and living in 802 nursing homes in Bavaria, Germany...
June 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28549702/iagg-iagg-garn-international-survey-of-end-of-life-care-in-nursing-homes
#15
Cara L Wallace, Daniel Swagerty, Mario Barbagallo, Bruno Vellas, Heung Bong Cha, Iva Holmerova, Birong Dong, Raymond Koopmans, Alfonso J Cruz-Jentoft, Luis Miguel Gutierrez Robledo, Juan Cuadros Moreno, Ramzi Hajjar, Jean Woo, Hidenori Arai, Jiro Okochi, Renuka Visvanathan, Samia A Abdul-Rahman, Ashish Goel, Andrea Moser, Yves Rolland, Angela M Abbatecola, Marcello Russo, John E Morley
This article reports the findings of a survey on end-of-life (EOL) care in nursing homes of 18 long-term care experts across 15 countries. The experts were chosen as a convenience-based sample of known experts in each country. The survey was administered in 2016 and included both open-ended responses for defining hospice care, palliative care, and "end of life," and a series of questions related to the following areas-attitudes toward EOL care, current practice and EOL interventions, structure of care, and routine barriers...
June 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28549511/infection-prevention-outside-of-the-acute-care-setting-results-from-the-megasurvey-of-infection-preventionists
#16
Monika Pogorzelska-Maziarz, Ericka L Kalp
BACKGROUND: In recent years, there has been a significant shift of health care delivery to nonacute care settings. However, research on staffing and resources dedicated to infection prevention and control (IPC) in these settings is lacking. METHODS: The data for this analysis come from the 2015 APIC MegaSurvey. Descriptive statistics were computed to describe infection preventionists (IPs) employed in nonacute care settings. Bivariate analyses were conducted to examine differences in facility and demographic characteristics by type of nonacute care setting...
June 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28549190/newborn-care-practices-and-health-seeking-behavior-in-rural-eastern-ethiopia-a-community-based-study
#17
Betemariam Gebre, Sibhatu Biadgilign, Zinaw Taddese, Kebede Deribe, Tsigereda Legesse, Meftuh Omar
Background: Most of the newborn deaths in developing countries occur at home. Up to two-thirds of these deaths would have been prevented if mothers and newborns had received known and effective interventions. The objective of this study is to determine newborn-care practices and health-seeking behavior in rural Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted in Adadle district, Ethiopian Somali Regional State. A multi-stage random sampling technique was applied...
May 26, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28549029/a-contemporary-approach-to-reoperative-aortic-valve-surgery-when-is-less-more
#18
Deane E Smith, Michael S Koeckert, Patrick F Vining, Elias A Zias, Eugene A Grossi, Aubrey C Galloway
OBJECTIVE: Although the benefits of minimally invasive valvular surgery are well established, the applicability of extending these techniques to reoperative aortic valve surgery is unknown. We evaluated our experience with a minimally invasive approach to this patient population. METHODS: From January 2010 to September 2015, 21 patients underwent reoperative isolated aortic valve replacement via a minimally invasive approach by a single surgeon. All patients had preoperative evaluation with computerized tomography and coronary catheterization...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28548914/quality-of-paediatric-hospice-care-for-children-with-and-without-multiple-complex-chronic-conditions
#19
Lisa C Lindley, Jessica Keim-Malpass
BACKGROUND: Hospice care for children with multiple complex chronic conditions (MCCC) is complicated given their unique health at the end of life (EOL). Little is known about the quality of the hospice care MCCC children receive and how that might differ from children without MCCC. OBJECTIVE: To compare the quality of hospice care (i.e., structures, processes, outcomes) between children with and without MCCC. METHODS: This retrospective, comparative study used data from the National Home and Hospice Care Survey, which included a nationally representative sample of paediatric hospice patients...
May 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28547207/role-of-out-of-hours-primary-care-service-in-limiting-inappropriate-access-to-emergency-department
#20
Andrea Posocco, Maria Paola Scapinello, Irene De Ronch, Francesco Castrogiovanni, Gianluca Lollo, Guglielmo Sergi, Iginio Tomaselli, Loris Tonon, Marco Solmi, Daniele Pescador, Elena Battistuz, Stefano Traversa, Vincenzo Zambianco, Nicola Veronese
Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013...
May 25, 2017: Internal and Emergency Medicine
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